Stinging insect allergies. Assessing and managing.
BACKGROUND
Mortality secondary to insect sting anaphylaxis, though uncommon in this country, is a genuine risk to patients with venom hypersensitivity. A number of non specific and specific preventive measures are available to minimise this risk. They include proper patient counselling regarding sting avoidance and the use of self injectable adrenaline, as well as venom specific immunotherapy.


OBJECTIVE
This article attempts to review the spectrum of insect sting reactions, their appropriate assessment and subsequent management. Anaphylaxis is particularly emphasised with regard to first aid treatment and subsequent prevention.


CONCLUSIONS
The most common causes of insect stings in Australia are bees and wasps. Insect sting reactions cover a spectrum of responses, from normal to anaphylactic. Immunotherapy is indicated in those patients who experience anaphylactic responses. The presence of venom specific IgE must be demonstrated before commencing immunotherapy. Venom sensitive patients should be educated in anaphylaxis first aid with adrenaline self injectable syringes.
Glaspole
I
I
Department of Allergy and Clinical Immunology, Alfred Hospital, Melbourne.
Douglass
J
J
Czarny
D
D
O'Hehir
R
R
D000322:Adrenergic Agonists / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000209:etiology* / Q000517:prevention & control*; D000818:Animals; D000862:Ant Venoms / Q000506:poisoning; D000997:Antivenins / Q000627:therapeutic use; D001180:Arthropod Venoms / Q000506:poisoning*; D001315:Australia / Q000453:epidemiology; D001514:Bee Venoms / Q000506:poisoning; D004837:Epinephrine / Q000627:therapeutic use*; D006801:Humans; D006927:Hymenoptera / Q000145:classification; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D014862:Wasp Venoms / Q000506:poisoning
D000322:Adrenergic Agonists; D000862:Ant Venoms; D000997:Antivenins; D001180:Arthropod Venoms; D001514:Bee Venoms; D014862:Wasp Venoms; D004837:Epinephrine